- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $19.67 / $20.39 / $122.01
| Facility | 26 | $19.67 | $20.39 | $122.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.15 / $189.42 / $776.27
| Professional | | $157.15 | $189.42 | $776.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.60 / $206.10 / $467.91
| Professional | | $148.60 | $206.10 | $467.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.69 / $239.53 / $506.71
| Professional | | $154.69 | $239.53 | $506.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.91 / $224.31 / $558.70
| Professional | | $139.91 | $224.31 | $558.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.89 / $234.37 / $316.39
| Professional | | $77.89 | $234.37 | $316.39 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.79 / $22.20 / $29.97
| Professional | 26 | $7.79 | $22.20 | $29.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.08 / $229.56 / $410.00
| Professional | | $174.08 | $229.56 | $410.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.28 / $26.64 / $46.71
| Professional | 26 | $18.28 | $26.64 | $46.71 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $61.36 / $100.00 / $100.00
| Facility | 26 | $61.36 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,169.18 / $1,169.18 / $1,481.40
| Professional | | $1,169.18 | $1,169.18 | $1,481.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.91 / $214.62 / $558.54
| Professional | | $139.91 | $214.62 | $558.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $650.27 / $650.27 / $650.27
| Professional | | $650.27 | $650.27 | $650.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.83 / $189.56 / $260.64
| Professional | | $116.83 | $189.56 | $260.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.43 / $197.05 / $565.52
| Professional | | $129.43 | $197.05 | $565.52 |